Reliability and item content of the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT): Parts 1–3
Introduction
Autism Spectrum Disorders (ASD) are a set of neurodevelopmental conditions characterized by deficits in communication, social skills, and rituals and stereotypies (Matson, 2007a; Matson & Boisjoli, 2007; Matson & Wilkins, 2008a; Njardvik, Matson, & Cherry, 1999; Paclawskyj, Rush, Matson, & Cherry, 1999). One of the topics that has generated the greatest interest among parents, the popular press, and researchers in ASD is early detection and diagnosis (Lord & Luyster, 2006; Matson, Wilkins, & González, 2008). This trend, in large part, is bolstered by the fact that early intervention for children as young as 18 months to 2 years may be advisable (Ben-Itzchak, Lahat, Burgin, & Zachor, 2008; Matson & Smith, 2008). Despite this fact, no biological or genetic tests for the condition have been developed (Theoharides, Doyle, Francis, Conti, & Kalogeromitros, 2008). Therefore, the emphasis has been most fruitful in the area of scales which can be used to assess developmental skill sets and whether they deviate from the norm (Matson et al., 1996, Matson et al., 1998).
To date, only one methodologically sound measure for early identification has been developed specific to early detection. This measure, the Checklist for Autism in Toddlers (CHAT; Baron-Cohen, Allen, & Gillberg, 1992), has undergone additional revisions: the Modified Checklist for Autism in Toddlers (M-CHAT; Robins, Fein, Barton, & Green, 2001) and the Quantitative Checklist for Autism in Toddlers (Q-CHAT; Allison et al., in press), which is in development. This measure has promise but is limited to autism and is a screening instrument not aimed at aiding in diagnosis.
More recently, the Autism Spectrum Disorders Child Battery has been developed. The purposes of this measure are to aid in the diagnosis of Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), autism, and Asperger's syndrome. Additionally, it was devised to assess comorbid psychopathology and challenging behaviors. Good reliability and validity have been reported (Matson et al., 2008a, Matson et al., 2008c; Matson & Wilkins, 2008b).
The purpose of the present study was to extend this scale by using the same diagnostic categories and to test these items and overall content with very young children. This version of the scales was dubbed the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). A biscuit is defined as a small, sweet cake. Small and sweet are apt descriptions of the young children assessed. This study was aimed at establishing the reliability of all three parts of the BISCUIT (diagnostic, comorbid, challenging behaviors) with a sample of “at risk” children ages 13–37 months.
Section snippets
Participants
The sample consisted of 276 children ranging in age from 17 to 37 months (M = 26.83, S.D. = 5.27). There were 187 males and 89 females. The ethnic breakdown of the sample was as follows: 53.4% Caucasian, 39.8% African American, 1.7% Hispanic, and 5.1% other ethnicity. These children were all enrolled in a state-funded program that provides services to infants and toddlers who either have a developmental delay or have a medical condition that is likely to result in a developmental delay. Medical
Results
Descriptions, means, and standard deviations for the original 71 items on the BISCUIT-Part 1 are presented in Table 1. Five items were removed because of low-endorsement rates. The corrected item-scale correlations and mean inter-item correlations for the remaining 66 items are also presented in Table 1. Four additional items were removed because the item-scale and/or inter-item correlations did not fall within the ranges listed above. This final, 62-item version of the BISCUIT-Part 1 had an
Discussion
Early identification and diagnosis of ASD is a challenging yet very important topic for study. Furthermore, given the high comorbidity of psychopathology and challenging behaviors with this spectrum, assessment of these potential problem areas deserves systematic assessment as well (Applegate, Matson, & Cherry, 1999; Dawson, Matson, & Cherry, 1998; Duncan, Matson, Bamburg, Cherry, & Buckley, 1999; Holden & Gitlesen, 2008; Myrbakk & von Tetzchner, 2008; Ringdahl, Call, Mews, Boelter, &
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